North Carolina workers’ compensation law has an unusual rule that is a real trap for injured workers who do not know about it. This is the injury-by-accident rule, which means that many on-the-job injuries are covered by workers’ compensation only if the injury is the result of an accident.
An accident is not just a slip, trip or fall but can also be something much subtler, such as being injured by your new duties during the first or second day on a new job. In fact, an accident can be anything that interrupts your normal work routine and causes your injury, or it can be anything that interjects an untoward or unexpected event into your work routine that results in your getting hurt.
Any suddenly occurring injury to a large joint in the body such as the shoulder or knee, or to one of the extremities, such as the arm, the leg, hands or feet, requires an injury by accident to be covered. If the injury occurred because of some type of repetitive motion that accumulated over time, then we call it an occupational disease, and it can be covered even without an accident. If one develops a hernia or some type of a back or neck problem, those injuries can be covered even without an accident, so long as one can point to a specific traumatic incident of the work assigned.
For the purposes of a back injury, for instance, if you were to pick up a heavy box and injure your back doing that, that would be a specific traumatic incident and your back injury should be covered. However, if you picked up a heavy box and you tore your bicep tendon in your arm, or tore your rotator cuff or tore up your knee, then the question becomes, is picking up a heavy box part of your normal work routine? If it is, then you did not have an injury by accident and you are not going to be covered. If picking up a heavy box is not part of your normal job routine, then it may qualify as an accident and if you got hurt doing that unusual task, then we might be able to get your injury covered.
Many people lose their cases when they initially report their injury to the employer or the insurance company because, even though they had something unusual happen that would constitute an injury by accident, they failed to mention this detail when they report the injury or give the insurance adjuster a recorded statement.
We have seen many cases over the years where an injured worker seemed to have perfectly good injury by accident claim, except that when he or she gave the adjuster a recorded statement before getting legal advice, the worker failed to mention the little detail that made all the difference and showed that an accident had actually occurred and caused the injury. Once they get you on tape, it is really hard to go into court and have any credibility when you add the important details that you left out in the recorded statement.
One of the services we provide to injured workers in North Carolina is this: if you get hurt at work, call and talk to a lawyer at no charge before you talk to the insurance company’s representative. We can go over the facts of how you got hurt and point out which facts are important to share with the insurance adjuster. That way, if you had an injury by accident that did not involve a slip, trip and fall you’ll still be able to give an appropriate and accurate report to both your employer and the insurance company and not lose your case simply out of your ignorance about the injury-by-accident rule.
These consultations with us are always free, and they can save you thousands of dollars in lost benefits by simply helping you to report the injury and the incident in the most accurate way possible! Call 704-377-7677 or toll free at 866-326-3090, or contact us online.